| Study characteristics |
| Methods |
Study design: randomised controlled trial
Study grouping: parallel group |
| Participants |
Baseline characteristics
Meditation
Journal
Outside
Gratitude
Control (no intervention)
Overall
Age (mean ± SD): 44.4 ± 11.4 Sex (N (% female)): 20 (100%) Sample size: 20 Years of experience (mean ± SD): 2.24 ± 0.88
Included criteria: Full and part‐time nurses and nurse aides working any shift at a suburban, 225 bed, Level 1 trauma centre were eligible to participate.
Excluded criteria: NR
Pretreatment: NR
Compliance rate: 3 of the 18 nurses assigned to an intervention group did not complete the six‐week intervention (17%)
Response rate: NR
Type of healthcare worker: exclusively nurses |
| Interventions |
Intervention characteristics
Meditation
Type of the intervention: Intervention type 2 ‐ to focus one’s attention away from the experience of stress Description of the intervention: Participants were asked to meditate for approximately five minutes at work every day they worked during the six‐week period. Meditation was described as a way to enhance mindfulness and become present in the moment. Participants were assured there is no right or wrong way to meditate, it is normal for the mind to wander during meditation, and the most important thing is that they take the time to do it. Participants were asked to download a meditation app on their smartphone (i.e. Simple Habit). The Simple Habit app, for example, allows users to identify how much time they have (five minutes), where they are (work), and what they would like to emphasise (stress, frustration, energy, focus, procrastination). They are then guided through a meditation suited for the choices selected. Participants not wanting to download an app were shown how to search for five‐minute meditations on the web. Participants were instructed to use any quiet, private space available to them (conference room, compassion room, staff lounge) and to turn off any work phones or pagers during this time. Each participant was given a record keeping log to record the date worked, location of meditation, identification of which meditation was done, and length of time spent meditating. The number of sessions: every day they worked during the six‐week period Duration of each session on average: 5 minutes Duration of the entire intervention: 6 weeks Duration of the entire intervention short vs long: Short Intervention deliverer: NA Intervention form: Individual, at work
Journal
Type of the intervention: Intervention type 2 ‐ to focus one’s attention away from the experience of stress Description of the intervention: Participants were asked to thank three people and compliment three additional people at work every day they worked during the six‐week period. It was explained that the act of complimenting or thanking another person can be intrinsically rewarding and motivating. It can also increase a sense of connection/relationship between people. Participants were told that they could compliment and thank any person (colleague, visitor, and patient) they encounter during their work and that they should communicate a positive message. Each participant was given a record‐keeping log to record the date worked and positions, not names, of the people they thanked and complimented. The number of sessions: every day they worked during the six‐week period Duration of each session on average: 5 minutes Duration of the entire intervention: 6 weeks Duration of the entire intervention short vs long: Short Intervention deliverer: NA Intervention form: Individual, at work
Outside
Type of the intervention: Intervention type 2 ‐ to focus one’s attention away from the experience of stress Description of the intervention: Participants were asked to take a break outdoors at work every day they worked during the six‐week period. Participants were asked to spend a minimum of five minutes outdoors. Being outdoors was described as an opportunity to disconnect themselves from their work and to recharge themselves. Participants were told they could engage in activity (walking a path) or sit quietly (in the healing garden), but they were to turn off personal phones and work phones/pagers during this time. As the intent is to disconnect and refocus, participants were also asked to limit interaction with others during this time and instead focus on what they could hear, see, or smell around them. Each participant was given a record‐keeping log to record the date worked, location they went to outdoors, and time spent outside. The number of sessions: every day they worked during the six‐week period Duration of each session on average: 5 minutes Duration of the entire intervention: 6 weeks Duration of the entire intervention short vs long: Short Intervention deliverer: NA Intervention form: Individual, at work outside
Gratitude
Type of the intervention: Intervention type 2 ‐ to focus one’s attention away from the experience of stress Description of the intervention: Participants were asked to journal for a minimum of five minutes at work every day they worked during the six‐week period. Journaling was described as an opportunity to reflect on their experiences during their work shift and also as an opportunity to take the perspective of “the other”. The journaling could take any form the participant wished. Small three‐ring notebooks were provided with the following prompts glued to the inside cover, although they were not required to be used: how would the patient/visitor/colleague/observer describe this situation; the best thing that happened today was; what I would have done differently if I could; this was unexpected and here’s what I did; the situation that touched me the most today was; would you believe this happened; or the way I got through that was. Participants were asked to date each journal entry to keep track of how often they journaled during the six‐week period. The number of sessions: every day they worked during the six‐week period Duration of each session on average: 5 minutes Duration of the entire intervention: 6 weeks Duration of the entire intervention short vs long: Short Intervention deliverer: NA Intervention form: Individual, at work
Control (no intervention)
Type of the intervention: NA Description of the intervention: These participants were asked not to change anything in their work practise for six weeks. The number of sessions: NA Duration of each session on average: NA Duration of the entire intervention: NA Duration of the entire intervention short vs long: NA Intervention deliverer: NA Intervention form: NA
|
| Outcomes |
ProQOL ‐ Burnout
ProQOL ‐ Compassion Satisfaction
ProQOL ‐ Secondary Trauma
|
| Identification |
Sponsorship source: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Country: United States of America
Setting: 1 trauma center
Comments: NR
Authors name: Darcy Copeland
Institution: College of Natural and Health Sciences, University of Northern Colorado
Email: darcy.copeland@unco.edu
Address: Gunter Hall 3080, Campus Box 125, Greeley, CO 80639, USA
Time period: NR |
| Notes |
Pro_QOL_BO included in analysis 2.1.Intervention groups combined to create a single pair‐wise comparison |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Quote: "As participants were enrolled, they were randomized, using a list of random numbers generated from an online random number generator, into one of five groups: meditation, outside, gratitude, journal, or control." |
| Allocation concealment (selection bias) |
Unclear risk |
Quote: "Upon receipt of IRB approval, nurses and nurse aids were invited to participate via organizational email. As interested participants contacted the PI, they were screened for eligibility and a time was arranged to complete informed written consent procedures, the pre‐intervention assessment, and receive intervention instructions. As participants were enroled, they were randomized, using a list of random numbers generated from an online random number generator, into one of five groups: meditation, outside, gratitude, journal, or control."
As a list of random numbers was used it is assumed that the person who randomised patients could foresee allocation it is however unclear who performed randomisation. |
| Blinding of participants and personnel (performance bias)
All outcomes |
High risk |
Participants were not asked to change any other practise while at work; participants assigned to one intervention were not expressly discouraged from engaging in the other interventions. Participants were not blinded. |
| Blinding of outcome assessment (detection bias)
All outcomes |
High risk |
Participants were not blinded whereas outcomes were self‐reported |
| Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
2 of the 22 participants were not included in the analysis (9%). Reasons were provided. Participants who did not complete the study were more often male however loss to follow‐up is below our pre‐defined cut‐off point. |
| Selective reporting (reporting bias) |
Unclear risk |
No trial registration or no study protocol reported, nor did we find one. |
| Other bias |
Unclear risk |
Not recorded whether there were differences at baseline between groups. |
